硬膜外布比卡因-咪唑安定或/和曲马多用于术后镇痛

Comparison of Epidural Bupivacaine Midazolam or/and Tramadol for Postoperative Analgesia

目的：观察咪唑安定或／和曲马多在术后镇痛中的作用。方法：分别于硬膜外注入布比卡因（对照组，Ⅰ组，ｎ＝２０），布比卡因和咪唑安定（Ⅱ组，ｎ＝２５），布比卡因和曲马多（Ⅲ组，ｎ＝２５）及布比卡因、咪唑安定和曲马多（Ⅳ组，ｎ＝２５），比较术后镇痛效果。结果：布比卡因咪唑安定具有较好的术后镇痛效果。布比卡因加用咪唑安定和曲马多联用可提供更好的术后镇痛作用，并可明显减少阿片类药物用量。加用咪唑安定后主要副作用为嗜睡。结论：咪唑安定或／和曲马多与布比卡因硬膜外注射。

Objective: To evaluate the effect of midazolam and tramadol in postoperative analgesia. Methods: The postoperative analgesic effect was compared among epidural bupivacaine (group Ⅰ, n= 20), bupivacaine midazo1am (group Ⅱ, n= 25), bupivacaine tramadol (group Ⅲ, n= 25) and bupivacaine midazolam with tramadol (group Ⅳ, n= 25). Results: Epidural bupivacaine midazolam had better postoperative analgesic effect than bupivacaine alone. Epidural bupivacaine, midazolam with tramadol in combination provided a much effective postoperative analgesia, thus the narcotic requirements were signifi cantly reduced. The major side effect of epidural midazolam was somnolence. Conclusion: Midazolam and/or tramadol can be used in combination with bupivacaine epidurally, their postoperative analgesia effects are thus augmented.